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I' •. ~..- <br />MINE REPORT ~' ~~ <br />i <br />Nota-Please fill out this report carefully, write plainly and answer all questions fully. Be sere to <br />date the report and sign it. Fill out both aides of the sheet. <br />----~- ----- ----------, Colorado, -- -_~19~ _ <br />~~~ ~f ~ <br />BUREAU OF 11IINE5, STATR ON' COLORADO. <br />T. R. Henahen, Commissioner of Mince, <br />Denver, Colorado. <br />Sir: In aceordnnce with Section 4299, Revised Statutes, Colorado, 1908, I submit report ae follows: <br />Name of Company-Tlte_ _!~lS!t~_~`~-. __ __.. _ ~_______________ <br />Incorporated in the Stntc of__________________ U <br />------ - - -- - -- <br />----- - --- ------------ - <br />r--- <br />Principal oRice ----JY`~ --------- ------- --------------------------~ <br />_..-_ Shares, nt $__~ ° b per share. <br />Capital stock ___ ~~" _r ~~__ __,~ ___ <br />It a Cam .nY, <br />ell out tel. NaJ~ll~ P. 0. Addre ass <br />.Nate: otherwlw ,~ <br />l..ee It 6hnt ,,~~~~/' <br />Secretary -CIr-SN__'trLl--~ J~N__^--_t~`- ------- %_i E~~c!.fc- ~~i~-- <br />- ~ -- <br />Treasurer ---- --(,/q-~---~--~ - ---- ----------------------------- <br />If a Erm <br />or V.rtnenhlp, <br />fill ou[ ihb <br />rVate: otheraiw <br />leer. It h6nk <br />9'itle of Pnrtnerehip------------------------------------------------------------- <br />Partnm:=' Names P. 0. Addr~ <br /> <br />___- <br />lIa grr __ __. ______________________________ __..____-___..________________..___ <br />-"-----' --' Names of Owners P. O. Addresses <br />900-Pt. ----- ---------------- ---- - - <br />____________ If nellhcr ___________________________._-..___.____.._ __. -_. ______. _________ ______..-_ <br />cpnllLnY nOr <br />------------- I~artnen6l , <br />fill oul to - __.._____________________________..___________ <br />,pees <br />I _________ ____________.-______________________ _..___.._______..____..-. ....________... <br />_,._ I~~I1 geC ____-._ _______________~_. ..___ ____________________ _. __ <br />--------- titlur, names of claims: <br />------- <br />Patentcd 1Jnpntented <br />orkmen in tllc e~~~ w~z. ~,-~~~~~~i(_!'`__ ~,____ <br />- i/ <br />------------- e~1 ~ ~~{ ~` <br />-- L~----- ----- <br />_________________________'_-______Y_-____-__F_ ___ <br />_____________ <br />_. ___y_ <br />____________ <br />'fotul acreage pntentcd__~~=-- ----acres; unpntented______._______________-- --ucrca. <br />--- <br />------- --- <br />Do you own orlense these clalme4_________ ---------------- -- ------ <br />----Company. ~°`'---- ---- <br />_____________ if you lease the/m~give name_of company or person from whom lcuecd_ ___~r- _~-----____-- <br />!V1-~~ C --------------~-------- <br />(Over) <br /> <br />